O
RIGINAL
A
R
TICLE
RESUMO
Essa inves gação qualita va obje vou analisar a visão dos trabalhadores de uma Unidade Básica de Saúde quanto à presença no serviço de estudantes de graduação em enfermagem. Dezoito trabalhadores foram sujeitos de entrevistas semi-estruturadas, analisadas após transcrição. Na análise de conteúdo iden fi camos dois temas: A len fi cação e a vivifi cação do serviço e O (des)preparo para aprender e ensinar. Os resultados apontam para um processo de parceria ensino-serviço ainda em construção, em que os trabalhadores sentem-se aprendendo, mas também desvalorizados. Com a presença dos estudantes, a dinâmica do trabalho é modificada, tornando-se mais lenta. Ao mesmo tempo, a presença estudantil interroga as formas hegemônicas de atender rapidamente. Evidencia-se expectativa de colaboração nas ações, havendo preferência pelos estudantes dos últimos anos que executam procedimentos e não requerem acompanhamento constante. Concluimos que a aproximação entre universidade e serviços da Atenção Básica expõe tensões que, se analisadas cole vamente, podem engendrar novas formas de cuidar, ensinar e aprender.
DESCRITORES Atenção Primária à Saúde
Enfermagem em saúde comunitária Educação em Enfermagem
Programas de Graduação em Enfermagem ABSTRACT
This qualita ve research aimed to analyze the view of the workers at a basic health unit on the presence of nursing students at the service. Eighteen workers par cipated in semi-structured interviews, analyzed a er transcrip on. In the content analysis, we iden fi ed two themes: The slowing and quickening of service and The (un)pre-paredness to learn and teach. The results point to a process of teaching-service part-nership s ll under construc on, in which workers feel as though they are learning, but also feel devalued. The presence of the students changes the work dynamics, slowing it. At the same me, the presence of the students ques ons the hegemonic ways of rapid assistance. An expecta on of collabora on in ac ons is evidenced, there being a preference for students in the last years of undergraduate courses, who perform procedures and do not require constant accompanying. We conclude that the approach between university and pri-mary healthcare services exposes tensions which, collec vely analyzed, can engender new ways of caring, teaching and learning.
DESCRIPTORES Primary Health Care Community health nursing Educa on, Nursing Diploma Programs
RESUMEN
Inves gación cualita va que obje vó anali-zar la visión de trabajadores de una Unidad Básica de Salud en relación a presencia de estudiantes de enfermería. Dieciocho tra-bajadores fueron some dos a entrevistas semiestructuradas, analizadas después de su transcripción. El análisis de contenido temá co iden fi có dos temas: Desaceler-ación y vivifi cación del servicio y La falta de preparación para aprender y enseñar. Los resultados apuntan a un proceso de alianza enseñanza-servicio todavía en construcción, donde trabajadores se sienten aprendiendo, pero también desvalorizados. La dinámica laboral es modificada por presencia de estudiantes, desacelerándose. Al mismo empo, presencia estudian l incita formas hegemónicas de atender rápidamente. Se evidencia expecta va de colaboración en acciones, prefi riéndose a estudiantes de los
úl mos años que llevan a cabo procedimien-tos y no requieren supervisión permanente. Se concluye en que la aproximación entre universidad y servicios de atención primaria expone tensiones que, analizadas en con-junto, pueden determinar nuevas formas de cuidar, enseñar y aprender.
DESCRIPTORES Atención Primaria de Salud Enfermería en salud comunitária Educación en Enfermería
Programas de Graduación en Enfermería
Primary Health Care workers’ view on the
presence of nursing students
A VISÃO DOS TRABALHADORES DA ATENÇÃO BÁSICA ACERCA DA PRESENÇA DE ESTUDANTESDE ENFERMAGEM
VISIÓN DE LOS TRABAJADORES DE ATENCIÓN BÁSICA ACERCA DE LA PRESENCIA DE ESTUDIANTES DE ENFERMERÍA
Priscila Norié de Araujo1, Maria Aparecida Soares Viana2, Cinira Magali Fortuna3, Silvia
Matumoto4, Maria José Clapis5
1 Undergraduate nursing student, School of Nursing of Ribeirão Preto, University of São Paulo. Ribeirão Preto, SP, Brazil. priscila.araujo@usp.br 2 Nurse.
Licensee. Professor of the College Projection of Mid - Level Vocational Education. Ribeirão Preto, SP, Brazil. maria_viana61@yahoo.com.br 3 Nurse. Doctorate
in Nursing. Professor, School of Nursing of Ribeirão Preto, University of São Paulo. Ribeirão Preto, SP, Brazil. fortuna@eerp.usp.br 4 Nurse. Doctorate
in Nursing. Professor, School of Nursing of Ribeirão Preto, University of São Paulo. Ribeirão Preto, SP, Brazil. smatumoto@eerp.usp.br 5 Nurse.
INTRODUCTION
Nursing is a historically and socially cons tuted social prac ce(1). Within this theore cal perspec ve, we consider
that its agents may cons tute a group-subject(2) for
imple-menta on of care prac ces that materialize the radical defense of life(3) and health as a right of ci zenship.
Educa on of health workers plays the role of a major catalyst for change processes or maintenance of developed prac ces. It can naturalize and legi mate ways of thinking and ac ng, such as the prevalence of academic knowledge over popular knowledge, and the hierarchy and fragmen-ta on between knowledge and prac ce(4), but it can also
promote changes encouraging refl ec on and the produc on
of collec ve care projects(3). In the process of implemen ng
new forms of teaching and learning, it is important that undergraduate nursing students experience prac ce in health services as early as possible(5-6).
The mobiliza on of social actors to change health prac c-es and health educa on in the country has led to the formu-la on of the Na onal Curriculum Guidelines
(NCG)(5) for the courses in the area, including
nursing. For the NCG of the Undergraduate Nursing Course, nursing educa on should focus on the Unifi ed Health System (SUS) and
Primary Healthcare, ensuring care that meets social needs, considering humaniza on and quality of care guided by the principle of comprehensiveness(5).
Thus, areas not historically frequented by students and professors start composing learning scenarios, aiming to break the logic of school-service, a generally specialized hospital space, considered as a model for
the establishment of partnerships to enable the experience of the health network as it is, in order to rethink both teach-ing prac ces and individual and collec ve care(6).
This arrangement also aims to question the separa-tion between theory and practice and between scientific and popular knowledge. In university workspaces and health services there is knowledge that guide the prac-tices and relations(7), which mutually combine, modify
and produce themselves.
In this new perspec ve, the proximity of universi es with health services, especially in Primary Healthcare, has produced tensions that need to be recognized and analyzed to generate learning for all involved: workers, professors, students and administrators in educa on and health. In the micropoli cs of health work(8) those processes reveal and
conceal themselves, composing a plot that can engender both the reproduc on of ins tuted prac ces and the ger-mina on of new forms of knowledge/learning that target
Also in those microspaces, power rela ons develop that lead to establishment of hierarchical rela onships among workers and also among workers and users(3-4). These power
rela ons undermine the development of staff and interpro-fessional team work(9-11).
This research addresses the tension produced in those microspaces, from the perspec ve of primary healthcare workers when accompanying nursing students.
Studies on changes in nursing educa on based on the current NCG point out, as challenges for overcoming
ce fragmenta on, diffi cul es in cri cal-refl ec ve
profes-sional forma on(6,12-13), but do not explore the tensions that
exist in accompanying students from the perspec ve of the primary healthcare workers. This study is jus fi ed because
it contributes to this perspec ve, with the following guid-ing ques on: What is the primary healthcare workers’ view on the presence of nursing students in basic health units?
This research aims to analyze the view of the workers at a basic health unit on the presence of nursing students.
METHOD
This qualitative descriptive study was performed at a Basic Health Unit (BHU), selected according to the following crite-ria: 1) belonging to the western district of Ribeirão Preto, SP, agreed with the local manager, to perform assistance, re-search and educational activities at the
Universidade de São Paulo, Ribeirão Preto; 2) inserted into the Educa onal Program for Work - PET Health(14), a program aimed at
qualifying the educa on of health profes-sionals for SUS, through work educa on, with the construc on of collec ve projects that address the interdisciplinary, mul professional presence and teaching-service integra on; 3) being a basic health unit that does not have a Family Health team, because it is the most prevalent form of primary health care organiza on in the county, and 4) agreement to par cipate in the study.
A er presenta on of the project for the teams of three BHU that fulfi lled the inclusion criteria, a lo ery was used, because all were willing to par cipate in the study. A er needed clarifi ca ons, the subjects signed the Terms of Free and Informed Consent, sta ng their voluntary par cipa on. The project followed the ethical recommenda ons and was approved by the Ethics Commi ee of Ribeirão Preto Nursing School, under protocol number 1118/2010.
The research subjects were 18 workers of the BHU who related to nursing students in their work schedules. They were nominated by the unit managers, who iden fi ed them
as par cipants in the educa on of nurses. There were six community health agents (CHA), nine nursing assistants, one
...the proximity of universities with health
services, especially in Primary Healthcare,
has produced tensions that need to
be recognized and analyzed to generate
refused to par cipate, and the workers were addressed in the health unit itself. They indicated their schedule avail-ability and preferred loca on for the interview.
A search was performed in public documents available on the World Wide Web of the disciplines that perform ac vi es within primary care(15), confi rming with the
manag-ers which disciplines were involved in the BHU. Therea er, semi-structured interviews were conducted from May to June 2010, guided by the research objec ves.
The interviews were recorded, transcribed and ana-lyzed using content analysis(16) of a thema c modality(17),
which aims to discover the core meanings that compose communica on, in which their presence and frequency have meanings for the object analyzed. Three important steps are needed for the performance: 1st) Pre-analysis:
free-fl oa ng reading, cons tu on of the corpus,
on and reformula on of hypotheses and objec ves; 2nd)
Explora on of the material, and; 3rd) Treatment of results
obtained and interpreta on(16).
The analy cal framework that supported data inter-preta on was the work process in health(1,8), aspects of
teamwork(9-10) and the guidelines for educa on of health
workers and nurses(4-5).
The subjects were iden fi ed in the text conforming to
their professional category, through the acronyms CHA for community health agents, NA for nursing assistants, NT for nurse technicians and N for nurses, followed by a sequen al number.
The BHU received nursing students from two courses linked to the Ribeirão Preto School of Nursing, Universidade de São Paulo (EERP-USP)(15): Bachelor of Nursing, which lasts
four years, and Bachelor and Licensure Degree in Nursing, which lasts fi ve years. It also receives students linked to the
PET Health of EERP-USP, and of the den stry course at the
Universidade de São Paulo.
Ac vi es of fi ve disciplines are performed at this BHU. From the Bachelor course: Comprehensive Care II and Su-pervised Internship in Primary Care (SIPC); from the Bach-elor and Licensure Degree: Comprehensive Healthcare I and II (CH I and CH II) and Supervised Internship in Primary Care. The disciplines Comprehensive Care II and CH II are taught in the second year in both courses, with a work-load of 150 and 240 hours, respec vely, and comprise the development of individual and collec ve care to families in their life cycle(15).
The discipline in the Bachelor course is taught every semester with clinical immersions three days a week, in the morning; in the Licensure course, it is annual, with clinical immersions every fi een days in the a ernoon.
The ac vi es performed by the students are observing and implemen ng care and procedures consistent with their
of a professor and a nurse of EERP-USP who has the func on of suppor ng the prac cal ac vi es. At this point, students have more direct contact with the assistants, technicians and nurses, following assistance in pre-consulta ons, post-consulta ons, nursing post-consulta ons, newborn screening, medica on, immuniza on, dressing changes, home visits, among others. Professors follow ten students in clinical immersions and are dis nct in the two courses.
The SIPC for the Bachelor course provides 360 hours of workload in the fi eld and the Licensure course provides 210 hours. In SIPC there is direct par cipa on of nurses in the supervision of students at the BHU. The unit receives one to two students of each course in both semesters.
In the CH I discipline of the Licensure course, ac ons planned are: territorializa on, knowledge and ar cula on with social teams, approach to the principles and guidelines of SUS and primary health care, approach and follow-up of families. The contact of novice students is more common with CHAs, and sporadic with nurses and nursing assistants. At the BHU, ten students accompanied by a professor have clinical immersions in the a ernoon every fi een days. This is an annual discipline with a 180-hour workload.
The presence of students at the BHU is more frequent in the fi rst semester, and the distribu on of disciplines
fol-lows the logic of the school year, with a peak usage on one of the days of the week (Tuesdays).
RESULTS
The analysis of the interviews led to iden fi ca on of two
themes: The slowing and quickening of service and The (un)
preparedness to learn and teach.
The slowing and quickening of service
The view and expecta ons that the unit workers have about the students come from the organiza on of the work process at the BHU and from the hegemonic model of care that they follow. They also come from the teaching organiza on at the university and from the way that edu-ca on and services historiedu-cally ar culate. In this theme it was considered that the presence of students slows care while helping the service. The feeling of work devalua on emerges and also the possibility of quickening the care through youth, new ideas and refl ec on on the diff erence:
(...) We were satisfi ed with most fourth-year students that have been with us, they even end up taking charge of care under my supervision. So, what I think is, they bring no problems, okay, on the contrary, they end up helping because they are already fourth-years, they already have some practice, know some techniques, so we often need help and they end up helping us (...) (N2). (...) I do not like it. I prefer one to stay and observe, especially the early second year ones (NT1).
There were examples of valuing and devaluing of the work:
(...) I particularly like it. I think it seems that my work is more valued in the streets than with them (...) We are just a place for them (CHA 6).
We emphasize that the workers can experience the forma on of the undergraduate students from a given reference of how to be a nurse:
(...) We’ve even commented, we have contact with the student
and say: That one is going to be a real nurse, one that gets her
hands dirty and about some of them we say, That one will be a bossy nurse ... That one you can work with and you will never be
alone in a unit; and you know that some will leave the care behind and will only stay in their offi ces, it is bad to even say that (NT1).
The presence of students exposes the usual way of car-ing in which listencar-ing and refl ec on are o en not present, ques oning the ways of working and opening possibili es for experimen ng with new ways of care:
(...) All I ask is for them to have patience with us, because there are times that the patient makes us very serious (...) but some-times there are people who do not have much patience, right? Then the patient is cursing and we have to pay attention to the person that is on your side (...) So the person who is faced with the patient for the whole day, it is very hard not to have a time
that you get stressed out (...) (NA 6). (...) Also another patient,
she uses a wheelchair, she refused, the students went there, even proposed to bring her to the consultation, she came. I now take medications to her, (...), and the students always go there, so I think it’s a positive experience, never negative, at least in this part (CHA 4).
(...) you know, so I think that students do not bother me, on the contrary, (...) I like them because youth is always good (NA 7). (...) there are lots of good things they do. Our life here is so rushed that at times we do not see, but there are many ideas they give. Ah! That would be better that way. They have more time to think or they come from another unit, sometimes another person says something, so they sometimes bring some idea (...) (NA 6).
Another aspect to highlight is the building of bond be-tween workers and students that can produce a given grief because students pass and go:
(...) And we trade and talk, so I think it is good. But then, sud-denly, you know, they have to go. I have not lost the bond with many I have worked with, I lost bond here within the work, but from time to time they call me, I also call them. A friendship
The (un)preparedness to learn and teach
In this theme we present the view on the process of teaching and learning from the speeches of workers interviewed, sugges ng a prior student prepara on and engagement with users. It also points to a concep on of teaching/learning that occurs through passage of in-forma on, exchanges and hierarchies between workers and students, students and professors and professors and workers:
(...) ... their presence here with us is very important because we both pass and gain a lot of experience (CHA 1).
(...) I’ve had patients who stopped visiting them, on account of them not being prepared, the other times they scheduled and did not appear to visit the patient (CHA 5).
(...) They just say that the students will be arriving and staying for a certain period and that they will come here to learn and help us. That’s what they say, nothing else. (...) Some professors even come to us and introduce the groups of students, introduce themselves, it has happened a lot here. Professors, too, but at a management level, both here and there, the manager never said: Look, some students will come. The professors who brought the students were the ones to introduce them, only some, others not, they arrived with the students there, you suddenly saw strange people who were there like employees (NA 3).
(...) Sometimes the simple way I do it, them in the way they study it, they can combine it, improve it. (...) So I welcome everything they say to me. (CHA 2).
(...) They are the ones who have to follow, we don’t have to follow them, that is what was said but actually the opposite occurs: it seems that we follow them, as if they were the ones that impose themselves, but we know the families (CHA 6). (...) Sometimes we have a question and we ask them and they answer it. Like, yesterday, we had a class and there was also a student, she said lots of things too and it’s great because we get the day-to-day routine, you know, for us it’s all routine (NA 5).
There is an expecta on of workers to contribute to student learning, expec ng a return on that and also rec-ogni on of his work:
(...) what I have as experience is that for me it was very good, because they brought me a reasonable return, you know, be-cause they’re learning (CHA 4).
(...) They are interested only in our cases, not in us, in our daily life, no, (...) The student’s concern is with their professor. So the response to be given is to their professors (CHA 6).
The interviews pointed to the presence of students as an opportunity for an update:
(...) Yeah, we even learn from them, you know, because I’m a Nursing Assistant so my training is not technical like Nursing. There are many terms, many things that sometimes I am
talk-ing to them about and then I ask - How is it that you speak?
The more scientifi c terms, so I end up learning from them, you know? (NA7).
DISCUSSION
The results show the diversity of disciplines that perform prac ces at the Basic Health Unit studied. They are situated at specifi c moments of the undergraduate degree, have dif-ferent learning objec ves and provide educa on of profes-sionals with diff erent professional demographic profi les(18),
because the Lincensure and Bachelor Degree course aims at the educa on of nurses skilled at professional educa on, as well as nursing care.
Diff erences between students at the fourth and second years of undergraduate educa on were iden fi ed in the
words of the workers interviewed. Students at the fi rst or
fi h years are not directly men oned in the statements,
although there was reference to those students. The state-ment by NA 6, they go and help you check the pressure, set up the saline, there is nothing nega ve, just posi ve things, only the second-year ones disturb a li le bit, I’m not going to lie to you, pointed to the expecta on of the diff erence between the class years in performing tasks.
The analysis of the interviews showed that the oc-cupa onal categories viewed the presence of students from diff erent angles, which produced this fragmented contact, the result of the work process in health developed by the technical and social division of labor(1) and also the
process of academic work which s ll could not overcome the fragmenta on. This aspect reinforced power
ons that update the struggle between social classes in everyday services, according to the reference of the work process in health(1).
For nursing assistants and technicians, the expected performance of future nurses was that they were able to develop shared work. Thus there was the statement by NT1: That one is going to be a real nurse, one that gets her hands dirty (…) you know that some will leave the care behind and will only stay in their offi ces illustrated this per-spec ve, which would signifi cantly contribute to everyone’s
knowledge if it were made explicit and discussed with the team, professors and students. But it is bad to even say that, a considera on that could adver se a mode of opera on that closed down the possibility of explicit tensions, denied the possibility of rethinking the work and the emergence of new ways of rela ng, caring and learning.
The work shared with the nurse indicated a revision in power rela ons and this was a feature that could be learned and cra ed from educa on, but it related to broader as-pects, historically and socially cons tuted, legi mized by
In a study on teamwork in health(9), communica ve
on provides a possibility to move from a clustering team to an interac on team, so communica on can be the object of teaching and learning, able to denature asymmetric
ons between workers.
For the CHA who deal more with students in the fi rst years, the expecta on of recogni on of their work clearly emerges, because at the same me they realize the value of their work in the streets, they perceive themselves as an object in the educa on process: We are just a place for them...
S ll on the theme The slowing and quickening of service, we saw that workers indicated that care was slower with students. At the BHU, the concep on that being quick is syn-onymous with effi ciency prevailed, so we can make an anal-ogy of emptying the unit with the fl ood and ebb des, there being a joint eff ort of the workers so that the unit is empty. This movement occurs in streams in the early periods of the morning and a ernoon. In this process, the goals of care move from produc on of care to the produc on of proce-dures(8), with quickening establishing itself as an impera ve.
The model of care confi gured in the health service,
which is expected to be overcome with new arrangements for care and educa on, is s ll focused on individual care, fragmented and divided among the professional categories.
Interprofessional educa on in health(11) is a proposal that
points to a possibility of the joint learning of professionals from various health professions in the form of coopera on and team work(10). The fact that other workers of the BHU,
such as physicians, den sts, pharmacists and writers do not par cipate in the educa on of nurses indicates li le prog-ress in overcoming the fragmenta on of educa on among professions and in interprofessional development. Those professionals were not included in the research because they establish specifi c contacts with nursing students, directly expressing the current organiza on of the work process in health, fi xing workers in ght steps, pu ng prac ces into
hierarchies and compartments; and the educa on process, which is related to Flexner’s logic in the university, divided into departments, areas, disciplinary knowledge, even in a curriculum that announces itself as integrated.
Despite the specifi city of each profession and the need for specifi c learning, comprehensiveness, teamwork and the construc on of networks of care are needed for com-prehensive care, and it does so through an ar cula on of workers and prac ces.
The technical and social division of work, naturalized in the capitalist mode of produc on, is presented in the daily service through a predominance of exchange value(3), which
is cons tuted in a round of expecta ons of the presence of students and of the university in the service. One of those expecta ons is that students do the work: according to NA 3
stu-hard, which may explain the diffi culty with students in the early years who do not have enough prepara on to be in charge of care. Even for students at the last years, this type of worker/ student rela onship contributes li le to the exchange and discussion of aspects of care and management of the work.
Another way of expressing the social and technical division of work and the logic of exchange value in rela on-ships, expressed in the inducing policy of the Ministry of Health in Health PET(14) by sta ng that only university-level
workers can act as preceptors, ge ng grants to accompany students; a fact that discourages all other workers within the educa on process, and reaffi rms technical and scien fi c knowledge as a reference, not recognizing other knowledge relevant to the educa on of workers.
However, the presence of students quickens the daily life at the BHU as it explicitly provokes other forms of care, other possible knowledge, bringing up the tension produced by the diff erence. Diff erent ways of caring are considered as opportuni es to update the workers, diff erent ways of approaching families and organizing work. The expression:
they have more me to think is interes ng and denotes an uncri cal work, emp ed by the rou ne and the lack of space and me for refl ec on. The new, the external look,
youth seem to aerate and bring more life to work, with its confl icts and tensions that are challenging and pulsa ng.
The proximity between workers and students can enable the construc on of posi ve bonds, in which both experience more horizontal rela onships of exchange and solidarity. On the other hand, the frequent arrival and departure of stu-dents, intermediated by missing those that passed and le marks, can lead to avoidance of a achment and on of the use of the other: leave the students working hard.
In the second theme, the (un)preparedness to teach and learn, the concep ons of teaching and learning of the workers express themselves with strength and also the view on the educa on of this nurse. The concep on of teaching as passage of informa on is quite entrenched, as well as the hierarchy of knowledge and its owners. On the other hand, accompanying students enables the experience of posi on changes: students also teach, the one who teaches also learns, explicit in the speeches of NA 5 and CHA 1: we had a class and there was also a student, she said lots of things too and it’s great because we get the day-to-day rou ne (…) we both pass and gain a lot of experience.
Another ques on that arises is about the prepara on of the student that can be understood with respect to the technical aspects. In this aspect we saw that there was a preference for students in the last years and some impa ence with beginner students, and with respect to a prepara on for rela onships of commitment and accountability. This seems to be the prepara on that CHA 5 is referring to when she tells that I’ve had pa ents who stopped visi ng them and explains the withdrawal of the family due to the frustrated expecta on
The commitment to the families, the responsibility with what was agreed by the students, are a tudinal contents that need to be worked on within nursing educa on(12),
especially in the view of CHA. This is also the challenge of educa on, but will the CHA be able to talk about these
dif-fi cul es to professors and students?
The rela onships of students with families crosses the work of CHA, which can contribute much to the qualifi ca on of students, professors and workers, if they are heard as bearers of valuable knowledge and strengthened to occupy a space to speak in the forma on of nurses.
In the view of one of the agents (CHA 6), students were concerned with the professor, which expressed the actual rela onship in which, although several workers par cipated in the process of teaching-learning, the professor was the one who evaluated and assigned a grade to the student. A major challenge exists for other prac ces of care and educa on: building a democra c process of evalua on and refl ec on among all involved in the scenes of
learning-teaching-caring, which is certainly related to the revision of the power network.
The process of student introduc on at the BHU must be rethought, because it reproduces the social and technical division of work, with the manager and the nurses being the ones with access to the discussions on the educa on and pres-ence of students. The others are just told, They just say that the students will be arriving and staying for a certain period.
The collec ve discussion of these aspects may update new, less hierarchical views, allowing the displacement of the dispute between who follows whom expressed in the statement: They are the ones who have to follow, we don’t have to follow them. For the produc on of collec ve care guided by a logic of inclusion, solidarity and learning, the fragment illustrates how necessary the review of
ves is for health worker educa on.
In the scenario, there were openings observed in this direc on when it was made an explicit expecta on of being in fact a par cipant in this educa on process and not only a case archive: they brought me a reasonable return, you know, because they’re learning.
CONCLUSION
As contribu ons, this study points to tensions of knowing and analyzing the view of health workers about the presence of nursing students in primary healthcare. This process results from the approxima on of the university and the educa on of nurses in the areas of primary care that were less frequent un l the implementa on of the NCG. This process is currently experienced across the country by workers of primary health-care, managers, professors, students and users.
The fi ndings are unique and are not intended to be
Never-need for investment in academic/service dialogue, review and nego a on of expecta ons of performance among workers, professors, students, users and managers, review of aspects of incen ve programs for teaching-service inte-gra on, such as inte-grants of PET-Health only for university-level health workers, among others.
Limita ons consist of the fact that other subjects of this process should be listened to, like users, students, teachers and managers of health services.
By analyzing the view of workers of a BHU about the presence of nursing undergraduate students, we have seen that there is a mul plicity of views that vary according to the professional category, the place occupied in the social and technical division of work and the year of educa on of the student. Views that prevailed were the ones in which students help with work, update the worker’s knowledge, but slow the care. It was found that the presence of students
ques ons the manner of care in which minimal listening, fragmenta on and a focus on procedures prevails .
There was a predominance of teaching-learning con-cepts, such as passing informa on hierarchically among sectors and agents of this process. Students were seen as a homogeneous mass, only the fourth and second years stu-dents were dis nguished, but their learning needs were not diff eren ated, because the BHU received students from two nursing courses in diff erent years of educa on. This process may be related to the process of forma on of these workers themselves, with a predominance of a discipline teaching a discipline, fragmented and hierarchical, although with advances, such as the early immersion in health services.
We believe that collec ve spaces of discussion in health services with all agents involved can engender new forms of teaching-learning-caring-educa ng.
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